Suspected Arterial Vasospasm in Femoro-Femoral Venoarterial Extracorporeal Life Support

Extracorporeal life support (ECLS) is increasingly used worldwide in patients with life-threatening hemodynamic or respiratory conditions. The femoral venoarterial cannulation, whether percutaneous or surgical, is the simplest and quickest method; however, a number of vascular complications may occur. We present two cases in which, despite a well-placed reperfusion cannula in the superior femoral artery, apparent limb ischemia of the cannulated limb developed rapidly after ECLS implantation and was suspected to be caused by arterial vasospasm. Both cases were successfully managed with the injection of a vasodilator cocktail of verapamil, nitroglycerin, and lidocaine directly in the reperfusion cannula.